开胸术后乳糜胸的诊治体会(附21例报告)

Diagnosis and Treatment of 21 Cases of Postoperative Chylothorax

目的:总结分析开胸手术后发生乳糜胸的诊断及治疗。方法:回顾性分析21例开胸手术后并发乳糜胸的临床资料,再手术的时机及胸导管的结扎方法。结果:全组全部治愈,其中保守治疗6例,手术治疗15例。结论:本组开胸术后乳糜胸发生率为1.8%,一旦确诊应根据病情决定治疗方式,对每日800ml/d术后乳糜胸患者保守治疗应慎重,果断手术是积极有效的治疗方式,对术中怀疑有胸导管及其主要分支损伤,应游离结扎或盲扎胸导管,可取得满意效果。

Objective：To observe diagnosis and treatment of postoperative chylothorax of thoracotomy. Methods：Retrospective study 21 cases of postoperative chylothorax. Analyze the suitable time for operative treatment of chylothorax and the proper method of thoracic duct ligation. Results：Among 21 postoperative chylothorax, 6 case were cured by conservative and 15 cases were cured by operative treatments. Conclusion：The incidence of Postoperative Chylothorax was 1.8% in this study. Once the diagnosis is clear,the treatment should be done according to the condition. For postoperative chylothorax, if the amount of thoracic drainage fluid exceeds 800ml per day, conservative therapy should be careful. The decisive operation is active and effective. If thoracic duct injury is suspected,preventive surgical ligation of thoracic duct during the course of operation can decrease the incidence of postoperative chylothorax.